Canterbury DHB

Volume 10 Infection Prevention and Control

Decontamination of EquipmentDecontamination of
Equipment

Decontamination of Equipment
The aim of appropriate decontamination of reusable equipment is to prevent
patient to patient transmission of infectious agents. Cleaning the item of
equipment is the first step in the decontamination process and may be
followed by disinfection or sterilisation depending on the use of the
equipment and the risk of transmission of infection by that item.
Only equipment that can be effectively decontaminated must be used in
clinical areas.
1. Classification of equipment according to risk of infection
Critical

Items that confer a high risk for infection and must be sterile at the time
of use. This includes any objects entering sterile tissue, site or vascular
system.

Semi-critical

Items that come into contact with mucous membrane or non-intact skin
should be single use or sterilised after each use. Where this is not
possible, high level disinfection is the minimum level of reprocessing
acceptable.

Non-critical

Items that come into contact with intact skin, not mucous membranes.
Thorough cleaning after individual use or intermediate/low level
disinfection may be appropriate.

2. Cleaning

Cleaning is the most important step in the decontamination process.

Cleaning of equipment using detergent and warm water or a detergent
wipe will physically remove contamination, but does not necessarily
destroy the bacteria. Drying is also an important part of the process.
Cleaning is a pre-requisite before either disinfection or sterilisation.
Cleaning is adequate for most items which come into contact with
intact healthy skin.

3. Disinfection

Authorised by
Ref: 4809

Disinfection is a process which inactivates non spore-producing

infectious agents.
Thermal disinfection uses heat and water at temperatures that
destroy infectious agents.
Chemical disinfection is achieved by using an approved chemical
agent e.g. alcohol, sodium hypochlorite.
There are three levels of disinfection depending on the intended use of
the equipment, low, intermediate and high.
All disinfection products and processes must be approved by the
IP&C Service.

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Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Volume 10 Infection Prevention and Control

Decontamination of Equipment

Refer Appendix B for Dilution Instructions for chlorine based

disinfectants.

4. Sterilisation

4.1

Sterilisation is a process that destroys all micro-organisms, including

bacterial spores.
Sterilisation must only be carried out by an approved sterilising
service, e.g. CSSD/TSU by suitably qualified staff.

Storage of sterile items

Store sterile items away from direct sunlight in a clean, dust, insect and
vermin free room in a manner which protects the items from damage
or recontamination before reuse.
Sterile items stored on open shelving must be stored 25cm above floor
level.
Storage trolleys, bins and cupboards shall be kept clean and free from
dust.
A system of stock rotation should be in place.

5. Single Use Instruments and Equipment

Items labelled as single use only must not be decontaminated or

reprocessed for re-use on other patients.
Any exception to this has previously been subjected to review by the
Canterbury DHB Clinical Board. No new items will be submitted.
For further information refer to Online Manual Volume 11,
Reprocessing of single use medical devices.

6. Specialist Equipment
All specialist reusable equipment must have cleaning and decontamination
processes approved by the IP&C Service.

7. Decontamination of Equipment Prior to Inspection, Service or Repair

Purpose
To ensure all items of medical devices and equipment intended for
inspection, service, repair, or for return to the lending organisation, first
undergo cleaning and disinfection to reduce the risk of infection to any
person who may handle the equipment.
Policy

Authorised by
Ref: 4809

All equipment must be emptied of all potentially contaminated

secretions/fluids.
All disposable components, eg. plastic tubing, must be discarded by
the user.

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Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Volume 10 Infection Prevention and Control

Decontamination of Equipment

All equipment must have all outer surfaces cleaned with detergent and
water.
If contaminated with blood/body fluids or from an isolation room,
then the cleaning must be followed by disinfection with an approved
disinfectant and left to dry.
Metal equipment must be rinsed off with water (damp cloth) after ten
minutes and dried immediately.

8. Decontamination of Commonly Used Equipment

If equipment is contaminated with blood and body fluids, cleaning

must be followed by disinfection.
Equipment used for a patient in Contact Precautions must be cleaned
and disinfected according to IP&C policy prior to use on another
patient.

Table 1: Decontamination method and frequency for commonly used patient care
equipment
NB: Where detergent and water is referred to in this section, a detergent wipe may be used if available.

Equipment / Item
Ambubag

Anti-thrombotic hosiery
(TED stockings)_and
Anti slip socks
Auroscope

Babies bottles and Teats

Breast Pumps

Baby Scales

Baths

Birthing Pools
Bed Frames and Wheels
Authorised by
Ref: 4809

Method
Single use: Dispose of as infectious/medical
waste.
Reusable: Clean as per manufacturers
recommendations.
Single patient assigned.
Wash as per manufacturers recommendations.

Frequency
Single use

Wipe handpiece with detergent and water or

approved alcohol based surface wipe.
Use single use heads or sterilise reusable heads
via CSSD/TSU.
Bottles and teats are single use items and are
not reprocessed.
Use one immersion tank per mother.
Clean and rinse breast pump equipment, then
soak in diluted Presept (refer to dilution of
disinfectants).
Clean and disinfect breast pump machine with
an alcohol wipe.
On discharge: rinse breast pump and send to
CSSD to be packaged and re-sterilised.
Wash with detergent and water.
Allow to dry where required, disinfect with an
alcohol-based surface wipe.
Wash with approved cream cleanser.
Disinfect as required.

After each
patient use

Refer to Birthing Pool Cleaning policy.

Wash with detergent and water.

Page 3 of 10

Between patient
use
Single use

Single use
Change solution
daily

Between patient
use

After each
patient use
After each
patient use

After each

Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Equipment / Item
(see also mattresses)
Bedpans
Blood Pressure Cuffs (nylon)

Volume 10 Infection Prevention and Control

Decontamination of Equipment
Method
Disinfect in bedpan washer/sanitiser.
Wipe BP cuff, tubing and bulb using a
dampened cloth with detergent and water or use
a disposable detergent wipe.
Use a cap to cover flexiport hole for cleaning.
DO NOT IMMERSE TUBING OR CUFF.

Frequency
patient use
After each
patient use
Weekly

Isolation allocate B/P cuff to individual

patients until discharge.
Use disposable wipe with appropriate
disinfectant e.g sodium hypochlorite1,000ppm
(bleach) or alcohol-based surface wipe.
Cloth BP cuffs

Bowls (washing)
Cleaning Bucket (plastic)

Chairs (fabric covered)

Commodes

CPR Trolley
Crockery and Cutlery
Curtains / Window
Coverings
Change routinely, when visibly
soiled or as part of terminal or
bed space disinfection clean.
Black laundry bag.

Dressing / Procedure trolleys

Authorised by
Ref: 4809

Where fitted, remove cloth cover and wash

weekly with detergent and water. Allow to fully
dry before refitting for use. Wipe over cuff
inner/ hose/ bulb or connectors (do not
immerse).
Wash with approved cream cleanser, then
disinfect in washer/sanitiser and store dry.
Empty contents down toilet or sluice. Wash
with detergent and water, store dry, positioned
upside down.
Spot clean as required.
Hot water extraction clean/steam clean.
NOTE: Impermeable, wipeable fabrics are
advised for clinical areas.
Clean with detergent and water or spray with
toilet sanitiser solution (where available).
If soiled, clean then use an appropriate
disinfectant e.g. sodium hypochlorite 1,000ppm
(bleach) and allow to air dry.
Damp dust using a detergent wipe.
Wash in approved dishwasher.
Window curtains are sent to laundry.
Roller blinds are cleaned with detergent and
water.
Privacy Curtains are sent to laundry.
Shower curtains are sent to laundry.
Venetian blinds are removed for cleaning and
maintenance inspection/repair by specialist
venetian blind service.
(Venetian blinds are not recommended in
clinical areas unless between double glazing)
Use detergent and water.

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After each
patient use

6 monthly or if
contamination
with body fluid
occurs.
After each
patient use

Weekly
Yearly
Yearly
6 monthly
3 monthly
3 monthly

After each

Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Equipment / Item

Duvet inners and covers

ECG trolley, leads and
electrodes

Endocavity transducers and

probes
Examination equipment,
eg. Opthalmoscope, reflex
hammer, sonic aid transducer
(Doppler)
Examination Bed/Couches

Flower vases

Glucocard Monitor and

Storage Box
Gumboots

Hair Trimmers / Clippers

Hoist Equipment
IV Stands

IV Pumps

Linen Carriers

Authorised by
Ref: 4809

Volume 10 Infection Prevention and Control

Decontamination of Equipment
Method
Where required, disinfect with an alcohol-based
surface wipe.
Clean wheels regularly
Clean via laundry service (single patient
assigned only).
Ensure the ECG machine is disconnected from
the power supply before cleaning.
Wipe with alcohol-based surface wipe including
all leads and electrode buttons.
Requires high-level disinfection or sterilisation.
Refer to departmental specific procedure
manuals.
Wipe with detergent and water or approved
alcohol-based surface wipe.

Frequency
patient use

Use a paper cover or sheet to protect bed and

pillow.
Change pillow case daily.
If paper cover is unavailable, change linen
between patient use.
Clean couch bed with detergent and water.
Change vase water every two days (do not
discard in handwash basin).
Wash with detergent and water.
Store dry positioned upside down.
Wipe monitor with approved alcohol-based
surface wipe or swab.
Clean box with detergent and water.
Clean with detergent and water.
If soiled, clean then use an appropriate
disinfectant e.g. sodium hypochlorite 1,000
ppm (bleach) and allow to air dry.
Use trimmers with single use disposable heads.
Disposal via sharps container.
Wipe trimmer handles with detergent and water
Refer Appendix A
Wash with detergent and water.
If contaminated disinfectant with appropriate
disinfectant e.g. alcohol-based surface wipe,
sodium hypochlorite1,000 ppm (bleach).
Wipe with detergent and water.
Use an appropriate disinfectant e.g. sodium
hypochlorite 1,000 ppm (bleach), allow to air
dry.
Wash with detergent and water including base
and wheels.

Change paper
between patients.

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Weekly
Between patients

Weekly

After each
patient use

Weekly

Between patients
After each
patient use
Weekly
Weekly
Following use

After each
patient use

After each
patient use

After each
patient use
As required for
terminal clean
Weekly

Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Equipment / Item
Mattresses

Medicine cup/pill pottles

Mobility Aides, Walking
Frames, Crutches.
Mop (cotton head for wet
use)
Nail Clippers

Volume 10 Infection Prevention and Control

Decontamination of Equipment
Method
Wash with detergent and water.
Replace mattress if the cover is torn or damaged
whereby the foam inner of the mattress may
become contaminated.
Dispose of mattress as infectious/medical
waste.
Specifically designed mattresses (such as
airflow mattresses) should be cleaned in
accordance with manufacturers
recommendations.
If non-disposable, wash in approved dishwasher
or clean washer/sanitiser.
Wash with detergent and water.
Mops heads are laundered by the contracted
cleaning or laundry service. Store dry.
Send to CSSD for reprocessing.

Pillows

Treat as for mattresses.

Pulse Oximeter

Clean finger probe/ear sensor with alcohol

based surface wipe/swab.
Wipe with detergent and water or approved
alcohol- based surface wipe.
Disposable safety razor dispose in sharps
container.
Electric patients own only.
Defrost and clean weekly to prevent ice build
up.
Refer to Food and Water Hygiene section in
this manual
Refer to manufacturers guidelines / CDHB
Resuscitation Training Coordinator for full
cleaning instructions.
Wash with detergent and water.
Note: Yellow bag bins/stands are cleaned by
ward staff.
Reusable scissors for sterile use, e.g. dressings,
are returned to CSSD for processing.
Designated sluice room scissors - wash with
detergent and water and sanitise in ward
sanitiser.
Send to laundry service; place in black laundry
bag.
Wash with detergent and water.
If soiled, clean then use an appropriate
disinfectant e.g. sodium hypochlorite 1,000

Razors

Refrigerators
Medication
Food
Resuscitation Mannikins

Rubbish Bag Stands/Bins

Scissors

Sheepskins
Shower Chairs / Stools

Authorised by
Ref: 4809

Page 6 of 10

Frequency
After each
patient use

After each
patient use
After each
patient use
Daily
After each
patient use
After each
patient use
After each
patient use

Single-use

Weekly

Decontaminate
after each use
Weekly

After each
patient use
Daily
After each
patient use
After each
patient use

Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Equipment / Item

Volume 10 Infection Prevention and Control

Decontamination of Equipment

Slide Sheets/Lifting Belts

Method
ppm (bleach) and allow to air dry.
Refer to Sigmoidoscopy Guidelines, Infection
Prevention and Control Intranet site for detailed
instructions.
Refer Appendix A

Stethoscopes

Use alcohol-based surface wipe/swab.

Telephone

Clean with a detergent or alcohol-based surface

wipe.
Electronic or Tympanic
Use disposable sleeve or ear piece.
Wipe probe/handpiece with alcohol-based
surface wipe /swab.

Sigmoidoscopy Equipment

Thermometers (oral/axilla)
(Reusable only)

Frequency

Single patient
assigned.
After each
patient use
Daily
After each
patient use

Mercury
Single patient assigned thermometers.
Rinse with tepid water and detergent under tap,
dry with paper towel, then wipe with alcohol based surface wipe /swab.

Tooth Mugs and Bowls

Toilets (Patients)/Raised
Seats
Toilet Brushes

Tourniquets

Toys

Urinals
Authorised by
Ref: 4809

On discharge, clean in detergent and cold water

and soaked for one hour in diluted Presept
(140ppm) and store dry.
Single use: Dispose of as General Waste.
Reusable: Rinse and sanitise in
washer/sanitiser.
Clean with detergent and water or toilet
sanitiser solution.
Rinse in flushing water and store dry.
Sanitise in washer/sanitiser.
Wash with detergent and water and soaked for
one hour in diluted Presept (140ppm) and store
dry.
Use disposable tourniquets for patients in
isolation.
All shared toys must be able to be washed with
detergent and water. Toys must then be
disinfected by immersing in diluted Presept
(140ppm) for one hour or toys that cannot be
immersed, thoroughly wipe with an alcoholbased surface wipe. Soft toys must not be
provided unless exclusively for one childs use
or is disposed of after use.
(The Activity Room in Christchurch Hospital
has its own departmental procedures)
Rinse and sanitise in washer/sanitiser.

Page 7 of 10

After each
patient use
After each
patient use
Daily
Weekly
Weekly or when
visibly soiled
Single patient
use
Weekly or when
contaminated /
placed in mouth

After each

Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Volume 10 Infection Prevention and Control

Decontamination of Equipment

Equipment / Item
Urine Bag Holders/Stands

Vacutainer / Luer adapters

/ Blood transfer device

Wheelchairs

Method

Frequency
patient use

Single patient assigned only.

Metal urine bag holders/stands: Sanitise in
washer/sanitiser or disinfect with an approved
disinfectant between patients e.g. Sodium
Hypochlorite 1000ppm (bleach).
Plastic urine bag holders: Clean with detergent
and water and soaked for one hour in diluted
Presept (140ppm) and store dry.
Vacutainer / Luer adapters. Disposable/single
use (clear): Dispose of in sharps container with
needle attached.

After each
patient use

Single use

Vacutainer / Luer adapters. Reusable

(yellow/blue pronto device): Wash in detergent
and water and soaked for one hour in diluted
Presept (140ppm) and store dry (Selected
clinical areas only).

After each
patient

Vacutainer Blood transfer device- (e.g. Blood

culture) single use disposable.
Wash with detergent and water.
Disinfect with appropriate disinfectant when
required e.g. alcohol-based surface wipe,
sodium hypochlorite 1,000 ppm (bleach).

Single use
After each
patient use

Associated documents
CDHB Policies, Volume 11, Clinical: Reprocessing of Single Use devices (available
on CDHB intranet)
Reference
CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008,
available from
http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf

Policy Owner
Date of Authorisation

Authorised by
Ref: 4809

CDHB Infection Prevention & Control Service

11 June 2012

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Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Volume 10 Infection Prevention and Control

Decontamination of Equipment

Appendix A: Cleaning of Patient Handling Equipment

Item
Action
Frequency

Example

Comment

Hoist slings
Sliding sheets
Handling belts

Send to laundry in
black laundry Bag*

At end of patient stay or

when soiled.

Individually assigned.

Hoist
Standing lifter
Turntables

Wipe with detergent

and water after use.

At least weekly.

Wipe with disinfectant

(eg. Alcohol-based
surface wipe /chlorine
based solution) when
used on patient in
isolation.

Transfer boards

Wipe with detergent

and water after use.

Between patient use.

Wipe with disinfectant

(eg. Alcohol-based
surface wipe / chlorine
based solution) when
used on patient in
isolation.

Ref. 1599

Authorised by: Infection Control Service

August 2008

Note: The items shown may differ slightly from those in your clinical area.
*When sending items to the Laundry, ensure they are clearly labelled with return location, including hospital site. Laundry can arrange labelling.
Colour of laundry bag may vary depending on the hospital check local guidelines.

Authorised by
Ref: 4809

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Issue 6: June 2012

Review Date: June 2014

Canterbury DHB

Volume 10 Infection Prevention and Control

Decontamination of Equipment

Appendix B: Dilution Instructions for chlorine based disinfectants

Dilution Instructions for Presept* Disinfection Tablets
Disinfection
of:

Required
Concentration
of available
Chlorine

Blood spillage
General
environmental
use

Dilution Rates
0.5g
Tablets

2.5g
Tablets

5.0g
Tablets

10,000ppm

18 tab in
0.5L water

7 tab in 1L
water

9 tab in
2.5L water

1,000ppm

4 tab in 1L
water

4 tab in 5L
water

3.5 tab in
10L water

Additional
Instructions
Refer to policy
page
Wipe down surfaces
with disinfectantsaturated disposable
cloth.

Breast pumps,
1 tab in 2L
1 tab in
1 tab 20L Immerse for one
140ppm
rubber and
water
10L water
water
hour.
plastic tubing.
Diluted Presept solutions are unstable and should be freshly prepared daily

Sodium Hypochlorite 5% (Chlorwhite) Dilution Instructions

Disinfection
of:
Toilets,
Showers,
Baths, Sumps,
Sluices
Surfaces
Blood and
Body Spills

Required
Concentration
of available
Chlorine

Dilution
Rate

Undiluted
1,000 ppm
10,000 ppm

20mL/L
200mL/L

Application and
Exposure Time
Direct stream of product onto area being cleaned.
Agitate with brush or cloth.
Leave at least 10 minutes.
Rinse with water.
2 capfuls per litre of water.
20 capfuls per litre of water.
Use an equal volume of diluted chlorwhite
solution to spill volume.
Allow two minutes contact time to achieve
decontamination.

Instructions for Use of Presept and Sodium Hypochlorite (eg. Chlorwhite)

Steps
1
2
3
4
5

Note:

Action
Handle with care.
Wear gloves, plastic apron and eye protection.
Ensure adequate ventilation while diluting and avoid directly inhaling fumes.
Follow the manufacturers dilution instructions.
Recap liquid sodium hypochlorite bottle. Wipe around lid to remove undiluted
solution. Bottles of undiluted sodium hypochlorite should not be left in
patient/public areas.
Sodium Hypochlorite (eg. Chlorwhite) may remove colour from some carpet and
fabrics.

Authorised by
Ref: 4809

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Issue 6: June 2012

Review Date: June 2014